HomeMy WebLinkAboutMortgage_Whitehead.� STATEMENT OF MORTGAGE OR CONTRACT INDf
FOR DEDUCTION FROM ASSESSED VALUATION
s�ae F«m as�os �Fts r zo��
�° � Presmbed by Oepartment of Local Govemment Finance
HN
Coun Township Year
File Mark
INSTRUCTIONS: q
To be filed in person or by mad wifh Me CowtyAuditor o( the couMy where the proper(y is located. FEB fi 4 2009
Fd'mg Dates: 1 J Real P�operty: During the tt months be(we June 11 0/ the year the deduction is to be eflectiva.
2) Mobile Hames assessed urrder lC 61.1-7: Behveen January 15 and March 2 0( the year the deduttirn is to be eNecfive
See reverse side /w additiortal insWctions and qualificafions. ' � �7f�.�„ ,Q�
(amerarcontrad�er-see restricGms
� vdua ot mal propaly as d March 1. aneN y�r
ro, what is ha I her exeq share M iMerest?
If reme m reard is d'AlereN ihan Ihat ot applicanl, i�mte below:
Name of rtwrtgagee or cpN-act seller
XJ C.L.�J /CoOI — 6.-t�-T
/ ConUaC uda6tedness unpaid a of March 1,
ar /VVOOO
If owned witN someone oU
nddress or monqagce « mnuaa selle. (numnu arid sheel ary, slafe. aM z�a oop4y
\ CJ
Name of assig�ree a oth '-t mortgage
Address of assigriee (n /� -
vi:t�i�crNp�`/� / �J
oces eapicam own F �` ••^ S`° /� What Te�dng DisViG�
cauMy in Iridiare? •
,C[��-� 1\r
�—"7'Qx4.vq�/� IO '•••.• .•. JNTYAUDROR
J �l
D e d u c ti o n a p p r o v e d i n N e ar n o w�..... �� � 6 G
!7
20 _ � 2p � 20 _
Is the
spouse,
Reoo�d
❑Yes � No
peM1Y in Queslion:
PrupeAy � Mobile Hane QC 61.
s this deductian been requesletl on papn�y
alRenlyea/?
❑Yes ❑ No
20 20
oale (monN. daY. Y��)
I I We cerGfy under the penalry of perjury iha[ ihe above and fwegoing infomiation is We and cortetl and ihat tlie appiicanis was / were a resident of
� a and owner of the afwementioned properly on March 1, 2b
^(amers ha�name) . 1 �. Da�e (monlh. day, vea7
'\ address of applicarq (number
�S3 � v �
ainharized by tluly exearied Powe
dty, sfate. arM LP cade)
w
Addressofainhor¢edpason (numberaMsheeCcdy,sWle.aMLPwOe)